WHITNEY AMBER PETERSEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****83

License Status

NOT RENEWED

Business

First Name

WHITNEY

Middle

AMBER

Last Name

PETERSEN

Business Name

WHITNEY AMBER PETERSEN

Original Issue Date

01/16/2018

Effective Date

02/20/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60637

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022